Evaluation Of The Efficacy Of Jianpi Huayu Jiedu Decoction In The Treatment Of Chronic Atrophic Gastritis And Its Effect On G-17 And PG Based On The Theory Of Deficiency,Blood Stasis And Toxin

Objective:To evaluate the efficacy of Jianpi Huayu Jiedu Decoction in the treatment of Chronic Atrophic Gastritis(CAG)with spleen deficiency and toxin stasis syndrome and its influence on Gastrin-17(G-17)and Pepsinogen(PG)based on the theory of Deficiency,Blood Stasis and Toxin.Methods:From December 2019 to January 2021,60 patients who were admitted to the department of spleen and stomach diseases in the affiliated hospital of shandong university of traditional Chinese medicine outpatients and inpatients who met the inclusion criteria of CAG spleen deficiency and toxin stasis syndrome were selected,the patients were randomly separated into experimental group and control group,30 cases in each group.The experimental group was given Jianpi Huayu Jiedu Decoction,take warm half an hour after breakfast and dinner,200ml/time;the control group was given Weifuchun Tablets,4 tablets/time,3 times/d,take orally half an hour before meals,the course of treatment is 12 weeks.Observe and record TCM symptom scores,histopathological scores of the two groups of patients before and after treatment,detect the levels of G-17,PGI,PGII,PGI/PGII(PGR)and record the adverse reactions during treatment,evaluate its clinical efficacy and safety.Results:One patient in the experimental group dropped out,and a total of 29 patients completed the clinical study;there was no drop out in the control group,and a total of 30 patients completed the clinical study.1.Before treatment,the general data(sex,age,course of disease),the positive rate of Helicobacter pylori and TCM symptom score,histopathological score,G-17,PGI,PGII,PGR of the two groups of patients had no statistical difference(P>0.05),and they were comparable.2.The efficacy of TCM syndromes:The total effective rates of the experimental group and the control group were 89.7% and 63.3% respectively,and the experimental group was better than the control group(P<0.05).3.TCM symptom score:TCM symptom total score:After treatment,TCM symptom total scores of the two groups were significantly decreased compared with those before treatment(P<0.01),the experimental group was better than the control group and the difference was statistically significant(P<0.01).Single symptom score:After treatment,the scores of epigastric fullness,epigastric pain(dull pain or tingling),lack of appetite,fatigue,nausea retching,fecal sticky in the two groups were decreased to varying degrees compared with those before treatment(P<0.05 or P<0.01),the experimental group was better than the control group and the difference was statistically significant(P<0.05);after the treatment,the experimental group had a tendency to improve the dark complexion score(P=0.059),and the score of the control group was not statistically different from that before the treatment(P>0.05),there was no significant difference between the two groups in the score of dark complexion(P>0.05).4.Histopathological score:Single histopathological score:After treatment,the gastric mucosal chronic inflammation,activity,and atrophy scores of the two groups were decreased in different degrees compared with those before treatment(P<0.05 or P<0.01)and the experimental group was better than the control group,and the difference was statistically significant(P<0.05);after treatment,the intestinal metaplasia scores of the two groups were reduced compared with those before treatment(P<0.05),but there was no statistically significant difference between the two groups(P>0.05).Total score of histopathology:After treatment,the total score of histopathology in the two groups was significantly lower than that before treatment(P<0.01),the experimental group was better than the control group and the difference was statistically significant(P<0.05).5.Serum values of G-17,PGI,PGII,PGR:After treatment,the serum G-17,PGI,PGR values of the two groups of patients were significantly higher than those before treatment(P<0.01)and the experimental group was significantly higher than the control group(P<0.05).There was no significant difference in serum PGII values between the two groups before and after treatment(P>0.05).6.Safety evaluation:There were no obvious adverse reactions in the two groups of patients during treatment,no abnormality was found in blood routine,liver function,renal function and electrocardiogram before and after treatment,indicating that both treatment methods are safe.Conclusion:Jianpi Huayu Jiedu Decoction based on the theory of Deficiency,Blood Stasis and Toxin can effectively improve the symptoms of epigastric fullness,epigastric pain(dull pain or tingling),lack of appetite,fatigue in CAG patients with spleen deficiency and toxin stasis syndrome,and at the same time,it can increase serum values of G-17,PGI and PGR,relieve gastric mucosal inflammation,delay its pathological progress,and have the potential effect of preventing CAG carcinogenesis.